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| Posted: |
02 Apr 2008 |
| Published: |
01 Jan 2001 |
| Format: |
PDF
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| Length: |
3
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| Type: |
Product Literature |
| Language: |
English |
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ABSTRACT:
FACTS® PPO™ is a fully automated provider network processing module. This system provides you with a fully integrated database for providers (both practitioners and facilities). It gives you a comprehensive system for the management and control of all aspects of provider network maintenance, including the identification of network participants and contract management. All contracts are "date-specific" driven by date of service, giving you the added capability of unlimited contract periods.
The module works in a fully integrated fashion with the FACTS® CLAIMS & ENCOUNTERS™ system. As claims are processed, FACTS PPO will automatically re-price the claim based on the specific contract that the provider had in place at the time the service was rendered. This automatic repricing interacts in an online, real-time fashion.
The key features of this system include: unlimited number of PPOs per plan; unlimited number of providers per PPO; unlimited number of PPOs and contracts per provider; per diems for all services; reimbursement schedules; provider membership with multiple networks; full physician network reporting capabilities; electronic interface capabilities; conversion, modifier and relative value calculation capability.
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BROWSE RELATED RESOURCES:
Contract Management | Health Care Applications Software | Health Care Industry | Insurance Applications Software | Insurance Industry | Network Processing | POS |
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View All Resources
sponsored by FACTS Services, Inc. |
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